Localized Drug Delivery for Cardiothoracic Surgery

Access routes, devices and guidance methods for intrapericardial delivery in cardiac conditions

“…Two techniques were used for pericardial delivery with the PerDUCER® device: (1) subxiphoid access to the mediastinal space and (2) pericardial captures, puncture and insertion of guidewire and catheter. The introduction of the PerDUCER ® device is usually via a small incision in patients created on the median line below the xiphoid process, [39][40][41] although one study introduced the device via median sternotomy.…”

“…; (ii) through dosage forms where the drug has limited ability to translocate, such as patches, gels and implants. [1] Localized cardiac delivery is difficult to achieve via conventional delivery routes [1] such as intravenous (IV) and oral delivery, as these result in the drug being introduced into the bloodstream and systemic circulation, hence being subject to typical distribution and plasma protein binding effects which render specific localisation in the heart difficult.…”

“…This approach is suggested to improve the residence time of cells in the myocardium. [1] Thus, it is widely used in cell therapy for delivery of stem cells and derived cells into the heart, but it might precipitate ventricular fibrillation. [2] Meanwhile, intracoronary delivery involves injection or infusion in the coronary artery, which is used preferably post-MI and with percutaneous cardiac intervention (PCI), [3] but the use is limited due to occlusion of the artery.…”

“…The pericardium is subdivided into the parietal and visceral pericardium, as shown in FIG 1. The parietal pericardium is the outer layer, which is made up of a fibrous laminar (fibrosa) and serous laminar (serosa).…”

Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas

“…Research is also ongoing for more localized systems that avoid systemic circulation, thereby avoiding the associated toxicities of the drugs. LDDS revolve around the concept of, “Targeted Drug Delivery”, wherein a more direct access to the diseased organ or tissue is provided with minimal systemic circulation or metabolism of the drug [ 46 , 47 ]. LDDS are increasingly common for various cancers, including HNSCC, because they involve the addition of components to existing cancer therapeutics to adhere directly to the tumour cells on the endothelial surface [ 46 ].…”